Medi-Cal Managed Care Transition 'Rough' For Some People

California has moved more than a million people into Medi-Cal managed care, including children from the former Healthy Families program, and seniors and the disabled from fee-for-service care. Advocates say some patients have had a rough transition.

The state says managed care is organized and cost-effective. But Vanessa Cajina of the Western Center on Law and Poverty says some seniors and disabled people were not adequately informed they can keep their doctors to finish treatment.

“So even though it might not be a huge number of the total carve out, it’s the people who have much higher needs, maybe people who don’t speak English particularly well or have disabilities or cognitive impairments,” says Cajina.

Notifying enrolled people of their right to continue care, is one area the state says it’s learned from the managed care transition.

“Four-fifths of the time they ask for it, they get it. The problem’s been that not everyone knows that they can get continuity of care. So we need to do a better job,” says Toby Douglas Director of the Department of Health Care Services.

Some advocates say the state has handled the Healthy Families transition well; others cite concerns about services for autistic kids.

At least a million more people will be enrolled in Medi-Cal managed care plans in the coming years in part because of the Affordable Care Act.